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Hi John,
A group of us have just submitted a paper to a journal from a study we did exploring graduating nurses knowledge, intentions and beliefs around infection control. This study was conducted at 6 Australian universities late last year. There were a few things of interest, but the standout was the lack of knowledge of and correct application of transmission based precautions – given some clinical scenarios. This was very substandard.
That tells me that something is amiss when it comes to how we are delivering these messages to undergraduate nurses at least. It is possible that the same themes would apply to medical students.
Re the curriculum when I work, infection control measures are taught more formally very early on, including micro, but then subsequently integrated throughout individual units, including various clinical assessments. There is a particular focus on aseptic technique and hand hygiene. First year nurses are required to complete the HHA OLP. In the very last semester before they graduate (Year 3), we have introduced a new unit on emerging health issues. In this unit, antibiotic resistance is covered, alongside emerging infectious diseases and the various IPC measures. In covering antibiotic resistance, stewardship will be covered. One assessment item is a patient information leaflet – where students have to develop a patient information leaflet on C.difficile, influenza or antibiotic resistance. That is then peer marked and this forms the basis for their grade, for that one assessment item. Students are also required to undertake the HHA OLP again – we encourage the certificate is kept for their various new employers.
Thanks
BrettDear All
We are in the process of curriculum change and would be very interested in learning about other’s approach to this essential topic. [Needless to say, our College needs to develop a position on this I think! ]
Whilst I guess the basic topics are straightforward – Std and Tx based precautions, specific emphasis on 5 moments with practical training, aseptic technique learning and practical techniques, sterilisation and disinfection and environmental hygiene etc, I’m particularly interested in how people sequence the content and what activities are used. Are you for instance , training your students as peer HH or AT auditors? How does it couple in with training about microbiology and infection?
A related topic is AMS – that would also be of interest for people to share what they are doing please.
Best wishes
JohnDr John Ferguson
Director, Infection Prevention Service, Hunter New England Health
Locked Bag 1, Newcastle Mail Centre, NSW 2310
Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org
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Hi Fiona
Out of interest, the new EPIC guidelines (EPIC3) have been launched in the UK. EPIC guidelines are national evidenced based guidelines for preventing HAI in the NHS in England. Each recommendation has a grading (based on the level of evidence).
There is a new recommendation (for them) relating to cutaneous antisepsis when inserting a peripheral vascular device – “decontaminate the skin with at the insertion site with a single-use application of 2% chlorhexidine gluconate in 70% isopropyl alcohol (or povidone iodine in alcohol for patients with sensitivity to chlorhexidine) and allow to dry before inserting a peripheral vascular device”.
The systematic review processes supporting recommendations are detailed at the back of the guidelines.
The guidelines can be accessed here – http://www.sciencedirect.com/science/article/pii/S0195670113600122
The guidelines cover a range of IC practices.
Thanks
BrettDr Brett Mitchell
Senior Lecturer, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
Faculty of Nursing and Health
And
Lifestyle Research Centre, Cooranbong
[Description: Description: cid:image001.gif@01CC3C9F.F23555B0]Excellence in Christian Tertiary Education since 1897
185 Fox Valley Road, Wahroonga NSW 2076 AustraliaAvondale College Ltd trading as Avondale College of Higher Education
http://www.avondale.edu.au | http://www.designedforlife.meHi All,
In December last year NSW Health published a guideline called Peripheral Intravenous Cannula (PIVC) Insertion and Post Insertion Care in Adult Patients.
The recommendation for skin preparation states that
“For PIVCs that are inserted in Day only or Extended Day Only patients > 70% alcohol solutions/swabs should be used (to reduce unnecessary exposure to chlorhexidine when residual antimicrobial activity is not required”In the guideline appendix 5 it states that
“For a cannula that is likely to be in for <24hours, skin cleaning with at least 70% alcohol is sufficient"Our facility currently uses an alcoholic chlorhexidine skin prep for all PIVC insertions unless the person has a known sensitivity. We are currently reviewing this and are inclined to continue with this product as we have known of IVC related BSIs occurring when a PIVC has been insitu for less that the 24 hours outlined in this document.
We are interested to know what other facilities are using as skin prep for this cohort of patients.
Kind regards,Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
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There is an open access review on Norovirus in the latest edition of Healthcare Infection – released in the last couple of days.
It’s worth a read, covers a range of issues related to Norovirus.
Regards
BrettSenior Lecturer
Avondale CollegeSent from my iPhone
On 25/10/2013, at 5:21 PM, “CAMERON, Donna” <Donna.CAMERON@AUSTIN.ORG.AU> wrote:
Hi Terry,
We use contact precautions with standard single room only required and droplet precautions added if vomiting.
Regards,
Donna.
Donna Cameron
Manager Infection Control Team
Austin Health
P.O. Box 5555
HEIDELBERG Vic 3968
9496 6625
donna.cameron@austin.org.auHi everyone,
Always on a Friday afternoon!
We have had a great debate here about what sort of precautions Norovirus requires and what sort of isolation room they need to be nursed in.The NSW Ministry of Health Infection Control policy PD2007_036 states:
Contact and Airborne precautions.
P2 mask when there is potential for aerosol dissemination e.g. patient vomiting or toileting (diarrhoea), disposing of faeces.
Airborne negative pressure room if available and P2 mask
Contact gown/apron, gloves
Ensure consistent environmental cleaning and disinfection.I have always advised the staff that contact and DROPLET precautions are required if the patient is vomiting or has profuse/explosive diarrhoea. I have also advised that a surgical mask is sufficient (if worn correctly). Our little ones dont vomit and expel faeces as far as adults do too.
We do not have the luxury of having a negative pressure room for them to be nursed in either as we do not have that many.
I think CDC simply suggests single rooms and contact precautions.Just thought I would ask the other experts out there what they think about this topic?
Also if I advise staff to follow the contact and droplet precautions and surgical mask route, am I going against policy?Any help on this matter would be appreciated. Happy to admit I am wrong!
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Childrens Hospital
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Dear all
Thank you to those of you who have completed the survey (details below). We have had a good response, but need many more people to complete it.
If you are an ICP in Australia or New Zealand and have not yet completed the survey, could you please consider doing so.
If you have completed the survey, could I ask you encourage any ICP colleagues you work with to complete it as well.
The first prize will be drawn in the next week.
Many thanks
Brett
Survey link – https://www.surveymonkey.com/s/infectioncontrolprofessionals
Dear Michael
I am leading a research project “Defining and optimal infection control model” which aims to describe infection control programs in Australian public and private hospitals and to establish national recommendations for health services on the required organisational support, staffing and skills.
This study has three main components
1. A survey of infection control professionals – regardless of where they work.
2. A survey of Australian infection control units – more information to come later this year.
3. Workshop
These three components will enable use to describe current ICP and hospital infection control unit demographics, roles, resources, governance arrangements and barriers to evidence based practice across Australia. Ultimately, we aim to make recommendations for health services on the required organisational support, staffing, skills and expertise. This is a really quick overview of this project.
What are we asking people to do?
So, now we are calling for all ICPs to assist with Phase 1 of the study, by completing an online survey (link below). The survey will take around 5-10 minutes to complete. I am urging all ICPs to complete this survey. This is your chance to be part of this project and contribute to fundamental professional issues. For those working with other infection control colleagues, I ask that you forward this email on and have attached a flyer to promote this further in your units.Prizes
In addition to the anticipated benefits this project will bring, we are also offering a range of prizes including an iPad, statistical software and infection control books. To go into the draw for these prizes, you must complete the survey and enter the draw upon its completion. The earlier people complete the survey, the most chances of winning.Please complete the survey now – https://www.surveymonkey.com/s/infectioncontrolprofessionals
Dr Brett Mitchell
Senior Lecturer, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
Faculty of Nursing and Health
And
Lifestyle Research Centre, Cooranbong
[Description: Description: Description: Description: cid:image001.gif@01CC3C9F.F23555B0]Excellence in Christian Tertiary Education since 1897
185 Fox Valley Road, Wahroonga NSW 2076 AustraliaAvondale College Ltd trading as Avondale College of Higher Education
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